Three-year risk of cervical precancer and cancer after the detection of low-risk human papillomavirus genotypes targeted by a commercial test.
Three-year risk of cervical precancer and cancer after the detection of low-risk human papillomavirus genotypes targeted by a commercial test.
复制标题
商业测试检测到低风险人乳头瘤病毒基因型后，宫颈癌前病变和癌症的三年风险。
DOI：
10.1097/aog.0000000000000013
复制
发表时间：
2014
影响因子：
7.2
通讯作者：
NewMexicoHPVPapRegistrySteeringCommittee
中科院分区：
文献类型：
--
作者：
Castle,PhilipE;Hunt,WilliamC;Langsfeld,Erika;Wheeler,CosetteM;NewMexicoHPVPapRegistrySteeringCommittee
目的：探讨人乳头瘤病毒（HPV）6、11和42型检测与宫颈癌前病变和宫颈癌的相关性。方法：我们使用来自新墨西哥州人乳头瘤病毒Pap登记处的数据。对来自379，000人的59，644份残留宫颈细胞学标本的分层样本进行HPV基因分型。我们测量了检测到单一HPV 6、11或42感染或单一或多重HPV 6、11或42感染后，2级或更严重（CIN 2+）和3级或更严重（CIN 3+）的3年累积发病率结果：HPV 6、11或42单一感染的总体患病率为0.8%（95%置信区间[CI] 0.7-0.9%）。HPV 6、11、42或组合感染（n= 581）后，CIN 2+和CIN 3+的3年风险分别为0.4%（CI 0.1-0.7%）（对于CIN 2+）和0.0%（对于CIN 3+）（贝内，由于没有发生事件，因此无法计算CI）。相比之下，阴性HPV结果（n= 27，522）后CIN 2+和CIN 3+的3年风险分别为0.2%（95%CI 0.1-0.2%）和0.1%（95%CI 0.0-0.1%）。结论：在没有高危HPV类型的情况下，检测HPV 6，11，42或组合并不能确定女性宫颈癌前病变的3年风险增加。HPV 6、11、42或这些类型的组合的检测应该停止，因为它没有被证明对patients.Level的好处：II人乳头瘤病毒6、11和42检测并不能有意义地预测宫颈癌前病变的发展，因此不应该包括在宫颈癌筛查。
OBJECTIVE:To investigate the risk of cervical precancer and cancer associated with detection of human papillomavirus (HPV) 6, 11, and 42.METHODS:We used data from the New Mexico Human Papillomavirus Pap Registry. A stratified sample of 59,644 residual cervical cytology specimens from a population of 379,000 underwent HPV genotyping. We measured the 3-year cumulative incidence of cervical intraepithelial neoplasia grade 2 or more severe (CIN 2+) and grade 3 or more severe (CIN 3+) after detection of single HPV 6, 11, or 42 infections or single or multiple infections of HPV 6, 11, or 42 (“HPV 6, 11, 42, or combinations”; n= 581).RESULTS:The overall prevalence of a single infection of HPV 6, 11, or 42 was 0.8%(95% confidence interval [CI] 0.7–0.9%). The 3-year risks of CIN 2+ and CIN 3+ after HPV 6, 11, 42, or combinations infections (n= 581) were 0.4%(CI 0.1–0.7%) for CIN 2+ and 0.0% for CIN 3+(nota bene, no CI was calculable because no events occurred), respectively. By comparison, the 3-year risks of CIN 2+ and CIN 3+ after a negative HPV result (n= 27,522) were 0.2%(95% CI 0.1–0.2%) and 0.1%(95% CI 0.0–0.1%), respectively.CONCLUSION:Detection of HPV 6, 11, 42, or combinations in the absence of high-risk HPV types does not identify women at increased 3-year risk for cervical precancer. Testing for HPV 6, 11, 42, or combinations of those types should be discontinued because it has no proven benefit to patients.LEVEL OF EVIDENCE:IIHuman papillomavirus 6, 11, and 42 testing does not meaningfully predict the development of cervical precancer and therefore should not be included in cervical cancer screening.